Developing a novel curriculum in medical cannabis for the supportive oncology context: Insights from palliative medicine program directors.

Abstract

331 Background: Patients’ interest in and use of medical cannabis (MC) continue to increase with expanding access, particularly in oncologic populations. We previously demonstrated that Hospice and Palliative Medicine (HPM) trainees discuss MC but lack the knowledge to make evidence-based recommendations. (PMID:38417464). We aimed to assess U.S.-based HPM program directors’ (PD) perspectives on MC educational needs, and developed a curricular intervention to meet these needs. Methods: We electronically surveyed 177 U.S.-based HPM fellowship PDs from October 2025 to January 2026. Survey domains included perceived importance and clinical utility of MC, preferred curricular formats and content, and barriers to curricular implementation. Results: Sixty-one PDs responded (34.5% response rate), representing programs across all major U.S. regions; most were based in academic hospitals (78.0%). Respondents practiced in states with variable MC legality: medical and recreational (50.8%), medical-only (33.9%), and illegal (13.6%). Most PDs rated MC knowledge as important for fellows (76.3%), and 88.1% supported its inclusion in fellowship curricula. Although 63.8% reported existing MC education, key barriers included limited faculty expertise and insufficient high-quality evidence (both 68.4%). When asked to describe an ideal curriculum, PDs preferred lectures (74.6%) and case-based teaching (72.9%), delivered mid-fellowship (52.5%) or during the first quarter (25.4%). Top curricular priorities were symptom management (98.3%), safety/drug interactions (91.5%), and pharmacology/formulations (86.4%). In response, our multidisciplinary team developed a one-hour, webinar-based curriculum grounded in adult learning theory, incorporating case-based discussions, communication strategies, and critical appraisal of MC evidence. Implementation is underway at multiple U.S. HPM programs, with pre-, post-, and 12-week follow-up assessments of trainee knowledge and confidence. Conclusions: HPM PDs identify MC education as essential yet constrained by limited expertise and evidence. To address this gap, we developed a scalable, evidence-informed curriculum focused on MC use in oncology patients, with national deployment in process; ongoing evaluation, utilizing pre- and post-curricular surveys, will inform iterative refinement and broader dissemination.